METHODS
The study protocol was approved by the Human Research Ethics Committee
of the Istanbul Aydın University (2020/169). The study was carried out
in full compliance with the World Medical Association Declaration of
Helsinki.
This cross-sectional study involved 100 children aged between 6-13 years
old who referred to Istanbul Aydın University Faculty of Dentistry
Department of Pediatric Dentistry with their parents for their routine
controls or dental treatment. The exclusion criteria included systemic
diseases, fixed/removable intra/extra oral appliance and lack of
cooperation. Written consent was obtained.
The data on sleeping habits were collected through parent proxy report
through Children’s Sleep Habit Questionnaire (CSHQ) that has 33
questions. It is segmented in four main subjects: bedtime resistance,
sleep behavior problems, sleep fragmentation and daytime sleepiness.
Each item has three response options regarding how often the
investigated conditions occurred the previous week. Frequencies were
coded as ‘usually’ if the specified behavior occured more than four
times a week, ‘sometimes’ for 2-4 times a week and ‘rarely’ for 0-1 time
a week. Presence of bruxism and history of traumatic dental injury was
recorded as well.
Intra oral examinations were done by one operator in order to avoid
inter-operator bias in a clinical setting. Carious lesions were recorded
using WHO criteria. The clinical examination included TMJ examination,
Angle Classification and malocclusion. Canines and incisor teeth and
adjacent soft tissues were examined for clinical findings of traumatic
dental injuries.
TMJ examination was rated according to Helkimo anamnestic and clinical
pain-dysfunction index. Lack of symptoms were encoded as ‘Grade 0’, mild
symptoms (feeling of fatigue in the muscles, muscle stiffness and / or
pain, masticating muscular disorders) were encoded as ‘Grade 1’and
serious symptoms (not being able to open the mouth too much, jaw locking
or dislocation, pain and limitation in mandibular movements, pain in the
area of the tmj and / or masticatory muscles, condyle-disc
irregularities in tmj) were encoded as ‘Grade 2’.
Occlusion was recorded according to Angle Classification and presence of
overjet, anterior open bite, overbite, crowding, spacing, crossbite was
also noted as malocclusion.